BACKGROUND Studies have reported that prophylactic continuous infusion of phenylephrine during spinal anesthesia for cesarean section can decrease the spread of local anesthetics. We investigated the ED50 of intrathecal hyperbaric ropivacaine in parturient women undergoing cesarean section under prophylactic infusion of phenylephrine. METHODS Sixty parturient women were allocated into 2 group...

We have investigated the effect of infusion of nimodipine on the spread of spinal anaesthesia in 50 patients undergoing transurethral procedures. Patients were allocated randomly to receive during operation continuous infusion of nimodipine 10 ml h-1 (group N, n = 25) or normal saline (group C, n = 25) in a double-blind manner. All patients received hyperbaric lidocaine 100 mg (5% in 8% dextros...

We have evaluated the influence of speed of intrathecal injection on lateral distribution of 0.5% hyperbaric bupivacaine. We studied 60 patients undergoing lower limb surgery who were placed in the lateral position with the operative side in the dependent position. After dural puncture (25-gauge Whitacre spinal needle), the needle aperture was turned towards the dependent side and 0.5% hyperbar...

BACKGROUND Despite decades of use, controversy remains regarding the extent and time course of cephalad spread of opioids in cerebrospinal fluid (CSF) after intrathecal injection. The purpose of this study was to examine differences between two often used opioids, morphine and fentanyl, in distribution in the CSF after intrathecal injection. METHODS Eight healthy volunteers received intrathec...

BACKGROUND Nonsteroidal antiinflammatory drugs are commonly used to treat postoperative and chronic pain. Animal studies suggest that these drugs act, in part, by blocking prostaglandin production in the spinal cord. The authors tested intrathecal ketorolac in patients with chronic or postoperative pain. METHODS After approval of the institutional review board and the Food and Drug Administra...

M EDICATION error has been an unfortunate chapter in the history of spinal anesthesia since its invention in 1899. Many catastrophic incidents have occurred from intrathecal injection of local anesthetics contaminated with other chemicals as well as the use of drugs not intended or approved for intrathecal administration. In such situations, patient outcomes depend on the nature of the contamin...

Available immunomodulatory and conventional steroid treatment options for patients with progressive multiple sclerosis (MS) only provide limited symptomatic benefit. We performed an open trial on the short-term and long-term efficacy and safety of repeated intrathecal application of the sustained release steroid triamcinolone acetonide (TCA) in 36 progressive MS patients. Six TCA administration...

Sensitization of the pain pathway is believed to promote clinical pain disorders. We hypothesized that the persistence of a sensitized state in the spinal dorsal horn might depend on the activity of protein kinase M ζ (PKMζ), an essential mechanism of late long-term potentiation (LTP). To test this hypothesis, we used intraplantar injections of interleukin-6 (IL-6) in mice to elicit a transient...

Intrathecal pertussis toxin injection has been used as a neuropathic pain model. In the present study, its effects on cerebrospinal fluid biochemistry and nociceptive behavioral expression were examined in rats. Cerebrospinal fluid dialysate samples were collected and pertussis toxin was injected using an intrathecally implanted dialysis loop catheter; samples were collected and hyperalgesia be...

BACKGROUND There is increasing interest in RNA interference in pain research using the intrathecal route to deliver small-interfering RNA (siRNA). An interferon (IFN) response is a common side-effect of siRNA. However, the IFN response in the spinal cord after intrathecal administration of siRNA remains unknown. We hypothesized that high doses of siRNAs can elicit off-target analgesia via relea...